Provider Demographics
NPI:1306905773
Name:STAATS, PAUL N (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:N
Last Name:STAATS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W PRATT ST STE 900
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-6808
Mailing Address - Country:US
Mailing Address - Phone:667-214-2507
Mailing Address - Fax:
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:UNIVERSITY OF MARYLAND PATHOLOGY ASSOCIATES PA
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1562
Practice Address - Country:US
Practice Address - Phone:410-328-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230596207ZP0102X
MDD68578207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD163877ZAP4Medicare PIN
MDP00861939Medicare PIN
MDCA9059Medicare PIN